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Sepsis and serious infection red flags
What is sepsis red flags?
Sepsis occurs when the body’s response to infection becomes dysregulated, causing widespread inflammation and impaired blood flow that can rapidly damage organs. Early signs can be subtle and may include fever or very low temperature, fast breathing, fast heart rate, confusion, extreme shivering, mottled or pale skin and reduced urine output.
Because sepsis can progress quickly, national campaigns emphasise the importance of recognising ‘red flag’ features – such as new confusion, very fast breathing, systolic blood pressure below 90, non-blanching rash or not passing urine – and seeking urgent help. First aiders are not expected to diagnose sepsis, but they should ‘think sepsis’ in anyone with suspected infection who looks seriously unwell and escalate without delay.
Sepsis is a life-threatening reaction to infection that can lead to tissue damage, organ failure and death, and is estimated to contribute to tens of thousands of deaths each year in the UK.
Who needs this skill?
Health & Social Care
In health and social care, sepsis recognition tools such as NEWS2 and SBAR handovers support early identification and escalation of deteriorating patients, especially older adults and those with comorbidities. Community staff and care homes must pay attention to soft signs like new confusion, not eating or drinking, or 'just not right' as possible early sepsis indicators.Licensed venues & nightlife
In nightlife and licensed venues, sepsis may follow injuries, injecting drug use or untreated infections, and early signs can be mistaken for intoxication; staff should take seriously any reports of feeling very unwell, severe pain, breathing difficulty or confusion in someone with possible infection and call 999 if concerned.Schools
Schools see many minor infections, but must also recognise when a pupil or staff member looks seriously unwell and needs urgent assessment, especially after recent illness or surgery.Workplaces
In workplaces, first aiders may see staff or visitors with suspected flu, chest infection, urinary infection or wounds who suddenly become much more unwell; they should recognise red flags such as confusion, shortness of breath at rest, mottled or very pale skin, and not passing urine, and call 999 rather than advising self-care alone.How to manage sepsis red flags
- 1Look for signs of serious infection and deteriorationAsk about recent infections, injuries, procedures or intravenous drug use, and look for fever or very low temperature, shaking, very fast breathing, fast pulse, extreme pain, pale or mottled skin, not passing urine and new confusion or slurred speech.Trust carers, family and staff who say 'they are not themselves' or 'something is very wrong' - this subjective concern is often present in sepsis.
- 2Call 999 if red flag features are presentIf someone with suspected infection has any red flags - such as very fast breathing, severe breathlessness, new confusion, mottled or bluish skin, rash that does not fade, inability to pass urine or signs of shock - call 999 immediately and say you are worried about sepsis.Do not delay escalation while trying to find a perfect label; it is safer to over-call than to miss evolving sepsis.
- 3Support airway, breathing and circulationHelp the person into a position that eases breathing (usually sitting up), loosen tight clothing, keep them warm but not overheated, and be ready to start CPR if they become unresponsive and stop breathing normally.Avoid giving anything to eat or drink if they are drowsy or at risk of vomiting; focus on airway protection and monitoring.
- 4Gather information for ambulance crewsNote the onset and duration of symptoms, recent infections, antibiotics, surgeries or hospital admissions, and any long-term conditions or medicines, particularly immunosuppressants or steroids.Provide this information in a structured handover such as SBAR or ATMIST where possible.
- 5Monitor closely while waitingStay with the person, reassess breathing, pulse, level of consciousness and skin colour frequently, and be prepared for rapid changes.Document your observations and timings carefully; sepsis outcomes and any later investigations often hinge on recognising when deterioration was first noted.
This guide is a learning reference only. It does not replace attended, assessed first aid training.
Qualifying courses
Qualsafe Level 3 Award in Paediatric First Aid (RQF)
2 days
3 years
Common questions
Practical answers for employers, venue managers, and healthcare teams about sepsis red flags training.
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No; sepsis can develop from common infections such as urinary tract infections, chest infections or skin infections in otherwise healthy people, although risk is higher in the very young, very old and those with long-term conditions. Any infection that is not improving or is rapidly worsening warrants attention.
Organisations can include sepsis red flags in deterioration training, encourage staff and carers to speak up if ‘something is not right’, and establish clear escalation pathways to urgent care and 999. Regular incident reviews and sharing learning from near-misses or serious cases also help build a safety culture around infection.